title: Target vessel detection by epicardial ultrasound in off-pump coronary bypass surgery.
abstract: OBJECTIVE
  The detection of embedded coronary arteries is difficult especially in off-pump coronary bypass surgery. From June 2010, we introduced high-frequency epicardial ultrasound (ECUS) to assess and evaluate embedded arteries during off-pump coronary bypass surgery.
  
  
  METHODS
  Between June 2010 and June 2011, a total of 89 consecutive patients underwent isolated coronary bypass surgery at our institution. The patients consisted of 72 men and 17 women with a mean age of 67.9 years. We routinely use the VeriQC system (MediStim, Oslo, Norway) to detect the target vessels in the operation. The patients were assigned to one of two groups, depending on whether ECUS was used in the operation (n = 10, ECUS group) or not (n = 79, non-ECUS group). We analyzed the impact of introducing the ECUS in terms of operative outcome.
  
  
  RESULTS
  All patients underwent revascularization using the off-pump technique without emergent conversion to cardiopulmonary bypass during surgery. The total number of distal anastomoses was 299, and 12 target vessels could not be identified either visually or on palpation. Thus, the frequency of the embedded coronary arteries was 4.01% (12/299 cases). The preoperative profiles of the two groups were not significantly different. Operation time was significantly longer in the ECUS group (P = 0.02). There were no significant differences in postoperative outcome between the two groups.
  
  
  CONCLUSIONS
  In the present study, in which the target coronary arteries could not be detected either visually or on palpation in 12 (4.01%) of 299 cases, the use of high-frequency ECUS allowed all patients to undergo off-pump coronary bypass surgery without conversion to cardiopulmonary bypass during the operation. High-frequency ECUS is therefore useful in off-pump coronary bypass surgery.
authors.affiliation: From the *Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, Japan; and †Division of Cardiovascular Surgery, Oumikusatsu Tokusyukai Hospital, Kusatsu, Shiga, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Asai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Shiraishi
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010496:Pericardium / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*